Expression And Clinical Significance Of CD71 In Acute Leukemia

Research purposesFlow cytometry was used to detect the expression level of the surface antigen CD71 of acute leukemia cells,analyze whether the expression of CD71 and expression level are related to the clinical characteristics,efficacy and prognosis of patients with acute leukemia,and explore its clinical significance.MethodsA total of 169 acute leukemia patients who were admitted to the Department of Hematology,Zhujiang Hospital of Southern Medical University between February 2018 and December 2020 were collected.In the normal control group select 24 cases of bone marrow specimens and peripheral blood hematopoietic stem cell specimens from hospitalized patients with non-hematological tumors in our Hematology department.The method of using flow cytometry for CD71 surface antigen of the specimen and the mean fluorescence intensity detected.Synthesize the clinical data of patients with acute leukemia,including gender,age,blood routine,bone marrow morphology,karyotype analysis,leukemia fusion gene/mutant gene detection results,analyze the correlation between the above clinical features and the difference in CD71 expression levels.The time to confirm the diagnosis is calculated as the starting point of survival time,and all cases will be followed up until December 31,2020.Statistical analysisSPSS20.0 software was used to analyze and process the data.Normally distributed measurement data were represented by mean ± standard deviation,non-normally distributed measurement data were represented by median(minimum,maximum),and comparison of mean between groups was performed by independent sample t test.The sample rate is compared using the χ2 test or the Fish exact probability method,the measurement data uses the non-parametric Mann-Whitney U rank sum test;the KaplanMeier analysis method is used for the survival correlation analysis,The survival curve uses Log-rank test.P<0.05 considered the difference to be statistically significant.Results1.The positive rate of CD71 in AL is 97.0%(164/169).According to disease classification:the results showed that among the 169 patients with acute leukemia,the positive rate of CD71 in AML was 96.2%(102/106),the positive rate of ALL was 98.2%(56/57),and the positive rate of B-ALL was 97.8%(45/46),the positive rate of T-ALL was 100%(11/11),and the positive rate of MPAL was 100%(6/6).There was no statistical difference in the positive rate.2.The average fluorescence intensity is used to indicate the expression level of CD71.In the normal control group,the median MFI of CD71 was 28.465(10.21-68.55),the median MFI of CD71 in leukemia cells was 174.81(4.95-2010),and The median MFI of CD71 of nucleated red blood cells is 810.32(52.5-7049.26).CD71 was low expressed in the normal control group,and highly expressed in acute leukemia cells and nucleated red blood cells.Among them,the nucleated red blood cells had the highest expression intensity.ANOVA analysis showed that the comparison was statistically significant(P<0.001);The median CD71 MFI of other cell populations(including lymphocytes and granulocytes)is 40.355(3.71-87.76).Compared with the CD71 MFI of acute leukemia cells,the CD71 MFI of leukemia cells is higher than that of other cell populations,and the difference is statistically significant.(P<0.000);Among the various disease types,T-ALL CD71 expression intensity is the highest,followed by AML and B-ALL.The fluorescence intensity of AML and B-ALL,B-ALL and T-ALL was statistically different(P<0.05).3.In the correlation analysis with clinical characteristics,it was found that the there was no statistical difference in CD71MFI between genes with poor prognosis and better prognosis,normal karyotype and acute leukemia with complex karyotype(P>0.05);In ALL,there was a significant difference in MFI between the platelet<20x109/L group and the platelet>20x109/L group(P=0.026),the ALL with PLT<20x109/L the average MFI was was 524.67,and the ALL with PLT>20x109/L the average MFI was 169.64,suggesting that the higher the CD71 MFI,the higher the risk of bleeding,and the other clinical features have no significant correlation.4.The difference in the composition ratio of the clinical features of CD71 with different expression intensities.In AML,CD71 has a higher rate of expression in younger than 60 years old patients and relapsed and refractory relapsed AML.AML with low CD71 expression is accompanied by a larger proportion of t(8;22);In ALL,the greater the probability of high CD71 expression,the patients are younger than 60 years old,the lactate dehydrogenase is higher,the platelets are less than 20x109/L,and Newly diagnosed ALL;5.In the efficacy analysis,in ALL,the CR rate of CD71 with low expression was 92.9%,the CR rate of CD71 with high expression was 80%,and the ALLCR rate of CD71 with high expression was lower than that of the CD71 low expression group.The difference was statistically significant(P=0.007);in the survival analysis,in AML,the CD71 high expression group compared with the CD71 low expression group,the median survival time of the two groups of patients were 8.5 months and 14 months,respectively,the survival time of AML with high CD71 expression was longer Short,the survival curve is statistically significant(P=0.025).Conclusion1.CD71 is commonly expressed in acute leukemia,and low express in normal hematopoietic stem cells and other types of cells,suggesting that it’s a potential value as a therapeutic target for acute leukemia;2.In AML,the CD71 high expression group was compared with the CD71 low expression group,the CD71 low expression group has a higher proportion of good prognosis cytogenetic characteristics.The survival analysis results show that the survival time of the CD71 high expression group is lower than that of the low expression group,suggesting that the expression of CD71 may be related to the prognosis,and it is a bad prognostic factor;3.In ALL,the CD71 high expression group was compared with the CD71 low expression group.In the CD71 high expression group,the patients are more younger,the higher the risk of bleeding,and the higher the level of lactate dehydrogenase,there was no significant difference in survival time between the two groups.